Research

11 pages, 259 KiB

Open AccessArticle

Psychological Well-Being, Self-Esteem, Quality of Life and Gender Differences as Determinants of Post-Traumatic Growth in Long-Term Knee Rotationplasty Survivors: A Cohort Study

by Maria Grazia Benedetti, Ilaria Tarricone, Manuela Monti, Laura Campanacci, Maria Giulia Regazzi, Tiziano De Matteis, Daniela Platano and Marco Manfrini

Children 2023, 10(5), 867; https://doi.org/10.3390/children10050867 - 12 May 2023

Cited by 1 | Viewed by 1461

Abstract

Rotationplasty (RP) is a special surgical technique for bone tumors of the lower limb and is the chosen procedure for children under 6 with bone sarcoma in the distal femur. Leg reconstruction results in an unusual aspect of the limb potentially giving life-long [...] Read more.

Rotationplasty (RP) is a special surgical technique for bone tumors of the lower limb and is the chosen procedure for children under 6 with bone sarcoma in the distal femur. Leg reconstruction results in an unusual aspect of the limb potentially giving life-long emotional outcomes, especially considering the young age of most RP patients. Although the high level of the quality of life of these patients has been previously reported, aspects related to long-term psychological well-being, self-esteem and life satisfaction, particularly regarding the gender, procreation and parenting, have never been explored. The aim of this study was to assess the general degree of psychological well-being of RP patients, with specific reference to gender, procreation and parenting. Twenty long-term RP survivors of high-grade bone sarcoma participated in the study. They were administered the following validated questionnaires: HADS for psychological well-being (degree of anxiety and depression), Temperament and Character Inventory (TCI), RSES for self-esteem, SF-36 for quality of life, SWLS extended to life satisfaction, and ABIS for body image integration. Data on education, marriage, employment and parenthood were gathered. All the scores obtained were very close to normal references. The only gender difference was found for the TCI Cooperativeness scale, which was higher in women than in men. A satisfactory psychological well-being in terms of both self-esteem and integration of the prosthetic joint limb into one’s body image, with relatively limited amount of anxiety/depression, good quality of life, and good temperament and character traits, was found. No major gender differences were reported. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

12 pages, 1292 KiB

Open AccessArticle

Appropriate Use of Antibiotic and Principles of Antimicrobial Stewardship in Children

by Melodie O. Aricò, Enrico Valletta and Désirée Caselli

Children 2023, 10(4), 740; https://doi.org/10.3390/children10040740 - 17 Apr 2023

Cited by 1 | Viewed by 2048

Abstract

Antibiotics account for over 10% of the overall drug expense of the National Health System in Italy in 2021. Their use in children is of particular interest on one side, because acute infections are very common in children, while they build their immunologic [...] Read more.

Antibiotics account for over 10% of the overall drug expense of the National Health System in Italy in 2021. Their use in children is of particular interest on one side, because acute infections are very common in children, while they build their immunologic library of competence; on the other side, although many acute infections are expected and turn out to be of viral origin, caregivers will often ask the family doctor or primary care attending to reassure them by prescribing antibiotic treatment, although it may often be unnecessary. The inappropriate prescription of antibiotics in children may likely be a source not only of undue economic burden for the public health system but also of increasing development of antimicrobial resistance (AMR). Based on those issues, the inappropriate use of antibiotics in children should be avoided to reduce the risks of unnecessary toxicity, increase in health costs, lifelong effects, and selection of resistant organisms causing undue deaths. Antimicrobial stewardship (AMS) describes a coherent set of actions that ensure an optimal use of antimicrobials to improve patient outcomes while limiting the risk of adverse events including AMR. The aim of this paper is to spread some concept of good use of antibiotics for pediatricians or every other physician involved in the choice to prescribe, or not, antibiotics in children. Several actions could be of help in this process, including the following: (1) identify patients with high probability of bacterial infection; (2) collect samples for culture study before starting antibiotic treatment if invasive bacterial infection is suspected; (3) select the appropriate antibiotic molecule based on local resistance and narrow spectrum for the suspected pathogen(s); avoid multi-antibiotic association; prescribe correct dosage; (4) choose the best route of administration (oral vs. parenteral) and the best schedule of administration for every prescription (i.e., multiple administration for beta lactam); (5) schedule clinical and laboratory re-evaluation with the aim to consider therapeutic de-escalation; (6) stop antibiotic administration as soon as possible, avoiding the application of “antibiotic course”. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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14 pages, 1744 KiB

Open AccessFeature PaperArticle

Assessment of the Clinical Effectiveness of DRL Orthokeratology Lenses vs. Single-Vision Spectacles in Controlling the Progression of Myopia in Children and Teenagers: 2 Year Retrospective Study

by António Queirós, Pauline Beaujeux, Louisette Bloise, Aurélia Chaume, Jean Philippe Colliot, Dominique Plaisant Proust, Perrine Rossi, Bertrand Tritsch, Dominique Bastien Crinon and Jaume Pauné

Children 2023, 10(2), 402; https://doi.org/10.3390/children10020402 - 18 Feb 2023

Cited by 1 | Viewed by 2404

Abstract

The purpose of this study was to assess the effect of orthokeratology treatment with DRL lenses on the control of myopia progression compared with single vision glasses users (monofocal glasses). It was also possible to analyze the clinical efficacy of orthokeratology treatment with [...] Read more.

The purpose of this study was to assess the effect of orthokeratology treatment with DRL lenses on the control of myopia progression compared with single vision glasses users (monofocal glasses). It was also possible to analyze the clinical efficacy of orthokeratology treatment with DRL lenses for myopia correction in children and adolescents in a 2 year retrospective, multicenter study, performed in eight different ophthalmology centers in France. A total of 360 data records of children and adolescents with myopia between −0.50 D and −7.00 D at baseline visit, who completed treatment and had a centered outcome, were selected for the study from a database of 1271. The final sample included subjects undergoing orthokeratology treatment with DRL lenses (n = 211 eyes) and spectacle wearers (n = 149 eyes). After one year of treatment, the data analysis shows that the DRL lens has a refractive myopia progression control rate of 78.5% compared with the spectacle wearers (DRL M change = −0.10 ± 0.25 D, p < 0.001 Wilcoxon test and Glasses M change = −0.44 ± 0.38 D, p < 0.001 Wilcoxon test). Similar results were found after 2 years of treatment (80% with 310 eyes). This study showed the clinical efficacy of orthokeratology DRL lenses compared to monofocal spectacle wearers in controlling myopia progression in children and adolescents in a 2 year retrospective study. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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18 pages, 1238 KiB

Open AccessArticle

The Causes and Factors Associated with Infant Mortality Rate in Ethiopia: The Application of Structural Equation Modelling

by Endeshaw Assefa Derso, Maria Gabriella Campolo and Angela Alibrandi

Children 2023, 10(2), 397; https://doi.org/10.3390/children10020397 - 17 Feb 2023

Viewed by 1869

Abstract

Infant mortality rate is a proxy measure of population health. Previous studies on the infant mortality rate in Ethiopia did not consider measurement errors in the measured variables and had a one-directional effect; little emphasis was placed on testing multiple causal paths at [...] Read more.

Infant mortality rate is a proxy measure of population health. Previous studies on the infant mortality rate in Ethiopia did not consider measurement errors in the measured variables and had a one-directional effect; little emphasis was placed on testing multiple causal paths at the same time. We used structural equation modelling for a better understanding of the direct, indirect, and total effects among causal variables in a single model. A path analysis was part of an algorithm providing equations that were relating the variances and covariances of the indicators. From the results, the maternal mortality ratio (MMR) was significantly mediating the influence of out-of-pocket expenditure (OOP) on infant mortality rate (IMR), and the fertility rate (FR) was significantly mediating the influence of GDP to IMR (β = 1.168, p < 0.001). The GDP affects the IMR directly and indirectly while the OOP affects IMR indirectly. This study showed that there was a causal linkage between the World Bank Health and Population Variables for causing IMR in Ethiopia. The MMR and FR were found to be the intermediate indicators in this study. Through the indicators, FR had the highest standardised coefficients for increasing the IMR. We recommended that the existing interventions to reduce IMR be strengthened. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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10 pages, 284 KiB

Open AccessArticle

Measuring Violence Behaviours in the Context of Romantic Relationships during Adolescence: New Evidence about the Modified Conflict Tactics Scale

by Javier Ortuño-Sierra, Natalia Marugán Garrido, Andrea Gutiérrez García, Ana Ciarreta López and Tomas Camara-Pastor

Children 2023, 10(2), 297; https://doi.org/10.3390/children10020297 - 03 Feb 2023

Cited by 1 | Viewed by 1552

Abstract

The main purpose of the present study was to analyze the psychometric properties of the Spanish version of the Modified Conflict Tactics Scale (M-CTS) in adolescents. The M-CTS is a questionnaire that screens for intimate partner violence. Additionally, we studied the association between [...] Read more.

The main purpose of the present study was to analyze the psychometric properties of the Spanish version of the Modified Conflict Tactics Scale (M-CTS) in adolescents. The M-CTS is a questionnaire that screens for intimate partner violence. Additionally, we studied the association between the M-CTS and attitudes towards violence. The study included a sample of 1248 students in a cross-sectional survey. The M-CTS and the Attitudes Towards Violence (EAV) scale were used. The analysis of the internal structure of the M-CTS revealed that a four-factor structure was the best fitting solution. The M-CTS scores revealed evidence of structural equivalence by gender and age. The McDonald’s Omega indices were adequate for both victims and perpetrators models. Moreover, attitudes towards violence were positively correlated with measures of violence manifestations. Results found in the present study confirm the psychometric adequacy of the M-CTS scores and gather new evidence about its internal structure and measurement equivalence for its use in samples of adolescent and young students. The assessment of intimate partner violence may contribute to detect adolescents at risk for different forms of violence in the future. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

12 pages, 1012 KiB

Open AccessArticle

Diet Quality and Exhaled Breath Condensate Markers in a Sample of School-Aged Children

by Mónica Rodrigues, Francisca de Castro Mendes, Inês Paciência, João Cavaleiro Rufo, Diana Silva, Luís Delgado, André Moreira and Pedro Moreira

Children 2023, 10(2), 263; https://doi.org/10.3390/children10020263 - 31 Jan 2023

Cited by 1 | Viewed by 2366

Abstract

Exhaled breath condensate (EBC) analysis is a recently developed, non-invasive method used to identify and quantify biomarkers, mainly those coming from the lower respiratory tract. It seems that diet can influence the airway’s inflammation and change the exhaled breath composition. This study aimed [...] Read more.

Exhaled breath condensate (EBC) analysis is a recently developed, non-invasive method used to identify and quantify biomarkers, mainly those coming from the lower respiratory tract. It seems that diet can influence the airway’s inflammation and change the exhaled breath composition. This study aimed to assess the association between diet quality intake and markers in EBC among school-aged children. A cross-sectional analysis included 150 children (48.3% females, aged 7–12 years, mean age: 8.7 ± 0.8 years) from 20 schools across Porto, Portugal. We assessed diet quality through the Healthy Eating Index (HEI)-2015, which was estimated based on a single 24 h food recall questionnaire. EBC samples were collected, and we assessed their ionic content (Na⁺, K⁺) and conductivity. The association between diet quality and Na⁺, K⁺, Na⁺/K⁺ ratio and conductivity was estimated using logistic regression models adjusted for potential confounders. After adjustment, a higher quality diet score increases the odds of higher conductivity values of the EBC (aOR = 1.04, 95%CI 1.00; 1.08). Our findings suggest that a higher diet quality in school-aged children is associated with higher conductivity levels of the EBC. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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12 pages, 767 KiB

Open AccessArticle

The Family Caregiving Environment Associates with Adolescent Patients’ Severity of Eating Disorder and Interpersonal Problems: A Cross-Sectional Study

by Giorgia Baradel, Livio Provenzi, Matteo Chiappedi, Marika Orlandi, Arianna Vecchio, Renato Borgatti and Martina Maria Mensi

Children 2023, 10(2), 237; https://doi.org/10.3390/children10020237 - 28 Jan 2023

Cited by 1 | Viewed by 1504

Abstract

The quality of family interactions may be a critical factor for restrictive eating disorders (REDs). Adolescent patients with RED have interpersonal problems that can be inferred by observing their behaviours during family interactions. To date, the assessment of the association among RED severity, [...] Read more.

The quality of family interactions may be a critical factor for restrictive eating disorders (REDs). Adolescent patients with RED have interpersonal problems that can be inferred by observing their behaviours during family interactions. To date, the assessment of the association among RED severity, interpersonal problems, and patients’ interactive behaviours in the family is partially explored. This cross-sectional study aimed to explore how adolescent patients’ interactive behaviours observed during the Lausanne Trilogue Play—clinical version (LTPc) were associated with both RED severity and interpersonal problems. Sixty adolescent patients completed the EDI-3 questionnaire to assess RED severity using the Eating Disorder Risk Composite (EDRC) and Interpersonal Problems Composite (IPC) subscales. Moreover, patients and their parents took part in the LTPc, and patients’ interactive behaviours were coded as participation, organization, focal attention, and affective contact in all the LTPc four phases. A significant association emerged between patients’ interactive behaviours during the LTPc triadic phase and both EDRC and IPC. Better patients’ organization and affective contact significantly correlated with lower RED severity and fewer interpersonal problems. These findings suggest that investigating the quality of family relationships and patients’ interactive behaviours may contribute to better identifying adolescent patients at risk for more severe conditions. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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31 pages, 4182 KiB

Open AccessEditor’s ChoiceArticle

Infodemiology of RSV in Italy (2017–2022): An Alternative Option for the Surveillance of Incident Cases in Pediatric Age?

by Matteo Riccò, Antonio Baldassarre, Sandro Provenzano, Silvia Corrado, Milena Pia Cerviere, Salvatore Parisi, Federico Marchesi and Marco Bottazzoli

Children 2022, 9(12), 1984; https://doi.org/10.3390/children9121984 - 16 Dec 2022

Cited by 8 | Viewed by 2081

Abstract

The aim of this study was to evaluate whether or not online queries for Respiratory Syncytial Virus (RSV) retrieved by means of Google Trends™ and the Italian Wikipedia analysis program mirror the occurrence of influenza-like illnesses (ILI), as reported by the Italian Influenza [...] Read more.

The aim of this study was to evaluate whether or not online queries for Respiratory Syncytial Virus (RSV) retrieved by means of Google Trends™ and the Italian Wikipedia analysis program mirror the occurrence of influenza-like illnesses (ILI), as reported by the Italian Influenza Surveillance network (InfluNet). Estimated rates for ILI in the general population and in the age groups 0–4 years and 5–14 years were obtained for the influenza seasons 2017–2018 to 2020–2021. Similarly, a weekly fraction of online searches was retrieved for a series of terms associated with Respiratory Syncytial Virus. Next, trends for daily visualization of Italian Wikipedia Pages for Human Respiratory Syncytial Virus, Pneumonia, Bronchiolitis, Influenza, and Respiratory Failure were similarly retrieved. The correlation of all search terms with ILI was analyzed by means of Spearman’s rank correlation analysis. Among search terms associated with the clinical diagnosis of Respiratory Syncytial Virus infections, the occurrence of ILI was highly correlated only with Bronchiolitis in the age group 0–4 years (β 0.210, p = 0.028), while more generic search terms, such as Bronchitis, fever, influenza, and Pneumonia, were identified as effective predictors of ILI, in general and by age groups. In a regression analysis modeled with ILIs as the outcome variable, daily visualizations for the Wikipedia pages on Bronchiolitis were identified as negative predictors for ILI in general (β = −0.152, p = 0.032), ILI in age group 0–4 years (β = −0.264, p = 0.001) and 5–14 years (β = −0.202, p = 0.006), while Influenza was characterized as a positive effector for ILIs in the age group 5–14 years (β = 0.245, p = 0.001). Interestingly, not only were the search terms extensively correlated with one another, but all of them were also characterized by autocorrelation through a Durbin-Watson test (all estimates DW < 2.0) In summary, our study identified a complicated pattern of data visualization as no clear association between rates of ILI in pediatric age group 0–4 and 5 to 14 years was actually found. Finally, our data stress that the infodemiology option may be quite problematic for assessing the time trend of RSV infections in Italy until more appropriate reporting will be made available, by sharing estimates of Lower Respiratory Tract Infections, and through a more accurate characterization of younger age groups. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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18 pages, 2130 KiB

Open AccessArticle

Deliberative and Affective Risky Decisions in Teenagers: Different Associations with Maladaptive Psychological Functioning and Difficulties in Emotion Regulation?

by Marco Lauriola, Luca Cerniglia, Renata Tambelli and Silvia Cimino

Children 2022, 9(12), 1915; https://doi.org/10.3390/children9121915 - 07 Dec 2022

Cited by 2 | Viewed by 1662

Abstract

Using network analysis, we investigated the relationships between maladaptive psychological functioning, difficulties in emotion regulation, and risk-taking in deliberative and affective behavioral decisions. Participants (103 adolescents aged between 13 and 19 years, 62% boys) took the Cold (deliberative) and Hot (affective) versions of [...] Read more.

Using network analysis, we investigated the relationships between maladaptive psychological functioning, difficulties in emotion regulation, and risk-taking in deliberative and affective behavioral decisions. Participants (103 adolescents aged between 13 and 19 years, 62% boys) took the Cold (deliberative) and Hot (affective) versions of the Columbia Card Task and completed the Youth Self-Report (YSR) and the Difficulties in Emotion Regulation Scale (DERS). In contrast to the view that risk propensity increases from preadolescence to middle adolescence and decreases at later ages, our study revealed no age-specific trend. YSR syndrome scales were significantly correlated with risk propensity, but only in the Cold version. The YSR Thought Problems scale was the most central node in the network, linking internalizing and externalizing problems with risk propensity in the Cold CCT. Lack of emotional Clarity was the only DERS consistently linked with risk-taking both in correlation and network analyses. Maladaptive psychological functioning and difficulties in emotion regulation were linked with risk propensity in affective risky decisions through deliberative processes. The statistical significance of direct and indirect effects was further examined using nonparametric mediation analyses. Our study highlights the role of cognitive factors that in each variable set might account for risk-taking in teenagers. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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17 pages, 2035 KiB

Open AccessArticle

The Acute Effects of Cognitively Demanding Physical Activity on Inhibitory and Affective Responses in Children: An Online-Based Mixed Methods Approach

by Ricardo M. G. Martins, Emiliano Mazzoli, Michael J. Duncan, Cain C. T. Clark and Emma L. J. Eyre

Children 2022, 9(12), 1896; https://doi.org/10.3390/children9121896 - 02 Dec 2022

Cited by 1 | Viewed by 1917

Abstract

This online study investigated the acute effects of a cognitively demanding physical activity (CDPA) vs a simple physical activity (SPA) bout on children’s inhibitory and affective responses. Using a counterbalanced within-subjects’ crossover design, thirty-nine participants aged 9–12 years old (29 boys; M_age [...] Read more.

This online study investigated the acute effects of a cognitively demanding physical activity (CDPA) vs a simple physical activity (SPA) bout on children’s inhibitory and affective responses. Using a counterbalanced within-subjects’ crossover design, thirty-nine participants aged 9–12 years old (29 boys; M_age = 11 ± 1 years) performed a CDPA and a SPA bout online (via ZOOM) for 15 min. Inhibition (Stroop test) was measured at the baseline, 1 and 30 min following the physical activity (PA) bouts, and self-report measures of affect, mental and physical exertion were taken prior, during and post-PA. Additionally, 31 children took part in semi-structured focus groups to explore the factors affecting their enjoyment. The quantitative results suggest no significant differences on inhibitory responses, affect and physical exertion (all p > 0.05). However, the CDPA induced more mental exertion than the SPA did (p < 0.05). In the focus groups, four themes were identified: physical exertion (e.g., tiredness), social (e.g., teams/groups), environment (e.g., outdoors and competition) and emotional (e.g., fun/enjoyment). Some children (n = 18) reported that the CDPA condition confused them, and to make these activities more interesting and enjoyable, they suggested performing the activities outdoors (n = 15) and including other children as part of a group/team (n = 19). The findings suggest no additional benefit of a cognitively enriched physical activity compared to an SPA bout on the inhibitory responses, affect and enjoyment. Using the instructions provided and given the low cost, the easy administration and the minimal amount of equipment and time involved, either of the approaches may be used in a diversity of contexts (i.e., online, schools or outdoors), and it is worth exploring the effects of these conditions on other aspects of executive function. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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12 pages, 1171 KiB

Open AccessEditor’s ChoiceArticle

Physical Fitness Variations between Those Playing More and Those Playing Less Time in the Matches: A Case-Control Study in Youth Soccer Players

by Ana Filipa Silva, Filipe Manuel Clemente, César Leão, Rafael Oliveira, Georgian Badicu, Hadi Nobari, Luca Poli, Roberto Carvutto, Gianpiero Greco, Francesco Fischetti and Stefania Cataldi

Children 2022, 9(11), 1786; https://doi.org/10.3390/children9111786 - 21 Nov 2022

Cited by 6 | Viewed by 1705

Abstract

The purpose of this study was (i) to compare two groups (players with more vs. less match play time) regarding body composition, vertical and horizontal jumping performance, and aerobic capacity; and (ii) to test the relationships between physical fitness and play time. This [...] Read more.

The purpose of this study was (i) to compare two groups (players with more vs. less match play time) regarding body composition, vertical and horizontal jumping performance, and aerobic capacity; and (ii) to test the relationships between physical fitness and play time. This study followed a case-control design in which the outcome was playtime, and the causal attribute was physical fitness. Sixty-six youth male soccer players from under-16 (n = 21), under-17 (n = 19), under-18 (n = 12), and under-19 (n = 14) age groups were monitored for match play time during five months of observation. Inclusion criteria consisted of (1) no absence of more than a week due to injury or other conditions during the five months of observation and (2) physical assessments having been done simultaneously with those of the other players (at the beginning of the season). The exclusion criteria were (1) not participating in one week or more of training sessions, and (2) not participating in the physical fitness assessments. At the beginning of the season, players were assessed for anthropometry (height, body mass, skinfolds), countermovement jump, triple hop bilateral and unilateral jump, and aerobic capacity using the Yo-Yo Intermittent Recovery Test, level 2 (YYIRT). The group that played more time had significantly greater YYIRT results (+28.2%; p = 0.009; Cohen’s d = 0.664). No other significant differences were found between those who played more and fewer minutes. Moderate and significant linear positive correlations were found between YYIRT and play time in the under-19 group (r = 0.423; p = 0.031) and overall (r = 0.401; p < 0.001). In the case of the under-17 group, moderate and significant linear positive correlations were found between TSA and play time (r = 0.473; p = 0.041). This suggests that aerobic and anaerobic capacity is related to play time while jumping performance and fat mass seem not to play an essential role in play time. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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9 pages, 4415 KiB

Open AccessFeature PaperArticle

Quality of Ventilations during Infant Resuscitation: A Simulation Study Comparing Endotracheal Tube with Face Mask

by Myriam Santos-Folgar, Paula Lafuente-Filgueira, Martín Otero-Agra, Felipe Fernández-Méndez, Roberto Barcala-Furelos, Javier Trastoy-Quintela, Silvia Aranda-García, María Fernández-Méndez and Antonio Rodríguez-Núñez

Children 2022, 9(11), 1757; https://doi.org/10.3390/children9111757 - 16 Nov 2022

Cited by 2 | Viewed by 1686

Abstract

Background: There are few studies that analyze ventilation volume and pressure during CPR carried out on infants. The aim of this study was to evaluate the quality of the ventilations administered using a self-inflating bag with an endotracheal tube and a face mask [...] Read more.

Background: There are few studies that analyze ventilation volume and pressure during CPR carried out on infants. The aim of this study was to evaluate the quality of the ventilations administered using a self-inflating bag with an endotracheal tube and a face mask in manikins. Methods: a quasi-experimental simulation study with a randomized case crossover design [endotracheal tube (ET) vs. face mask (FM)] was performed. Sixty participants who were previously trained nursing students participated in the study. The estimated air volumes breathed, and the pressure generated during each ventilation were assessed and the quality of the chest compressions was recorded. Results: the ET test presented a higher percentage of ventilations that reached the lungs (100% vs. 86%; p < 0.001), with adequate volume (60% vs. 28%; p < 0.001) in comparison to FM. Both tests presented peak pressures generated in the airway greater than 30 cm H₂O (ET: 22% vs. FM: 31%; p = 0.03). Conclusions: performing quality CPR ventilations on an infant model is not an easy skill for trained nursing students. Both tests presented a significant incidence of excessive peak pressure during ventilations. Specific training, focused on quality of ventilations guided by a manometer attached to the self-inflating bag, must be considered in life support training for pediatric providers. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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9 pages, 239 KiB

Open AccessArticle

The Compatibility of Children with Obesity to Self-Report Aspects of Physical Activity Domains

by Liraz E. Anavi, Einat Kodesh and Gur Mainzer

Children 2022, 9(11), 1664; https://doi.org/10.3390/children9111664 - 31 Oct 2022

Viewed by 1215

Abstract

Questions about the different aspects of physical activity (PA) are commonly asked in the clinical setting, yet their compatibility for use with children, particularly children with obesity (OB) is uncertain. Our aim was to investigate different PA-related questions when compared to an objective [...] Read more.

Questions about the different aspects of physical activity (PA) are commonly asked in the clinical setting, yet their compatibility for use with children, particularly children with obesity (OB) is uncertain. Our aim was to investigate different PA-related questions when compared to an objective maximal cardiopulmonary exercise test (CPET) or validated questionnaires. For this study, 33 normal-weight (NW) (5 to less than 85% BMI percentile) and 35 OB (≥95% BMI percentile) children responded to three self-report PA questions evaluating PA domains (exercise capacity, limitations, and the maintenance of an active lifestyle); they also completed a maximal CPET and two validated questionnaires: the New York Heart Association (NYHA) questionnaire and the international physical activity questionnaire (IPAQ). The results regarding the NW children were highly compatible with their self-reports about exercise capacity (85%), whereas the compatibility was low (40%) in the OB group (p < 0.001). Both OB and NW groups had moderate compatibility between the self-report and objective findings regarding their exercise limitations and lifestyle with no significant differences between the groups. These findings suggest that it is inadvisable to rely on a single-item question by which to assess PA in OB children, and no definite conclusions regarding PA status should be drawn. NW children are more compatible with self-reporting their overall exercise capacity, with more limited compatibilities observed when self-reporting their limitations or lifestyle. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

13 pages, 243 KiB

Open AccessArticle

Challenges and Elements Needed for Children with Learning Disabilities in Teaching and Learning the Quran

by Hafizhah Zulkifli, Syar Meeze Mohd Rashid, Suziyani Mohamed, Hasnah Toran, Norakyairee Mohd Raus and Mohd Nasri Suratman

Children 2022, 9(10), 1469; https://doi.org/10.3390/children9101469 - 26 Sep 2022

Cited by 1 | Viewed by 2253

Abstract

People with disabilities have the same right to access education and, therefore, the space and opportunity to study the Quran as other groups. However, there are some issues regarding the teaching of the Quran to students with special learning needs, such as from [...] Read more.

People with disabilities have the same right to access education and, therefore, the space and opportunity to study the Quran as other groups. However, there are some issues regarding the teaching of the Quran to students with special learning needs, such as from the aspects of the level of readiness of teachers, the mastery of Islamic Education among teachers who teach Special Education, and the use of teaching aids to teach the Quran. Therefore, this study aimed to identify the challenges, the need to develop a model of teaching and learning the Quran, elements to be included in the development of Quranic teaching, and a learning model for children with learning disabilities. A qualitative methodology was adopted using a case study design. The sample consisted of eight informants who volunteered to be involved in this research. The results show that there are seven main challenges in the teaching and learning of children with learning disabilities, i.e., a lack of stimulus materials, a lack of knowledge, limited time, uncontrolled behavior, traditional teaching, disabilities, and a lack of parental commitment. Thereafter, three themes arose in terms of identifying why it is necessary to develop Quran teaching and learning models for children with learning disabilities, such as the lack of an up-to-date model and the right to education. In addition, there were four themes concerning the elements that need to be included in the development of teaching and learning models for the Quran for children with learning disabilities, i.e., digital teaching aids, visual, audio, and kinesthetic learning styles, activities graded by the level of ability, and sensory support. It is hoped that this study will provide guidance to teachers to further strengthen the teaching profession pertaining to educating children with learning disabilities. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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11 pages, 268 KiB

Open AccessArticle

Externalizing and Internalizing Behaviors in Children with ADHD during Lockdown for COVID-19: The Role of Parental Emotions, Parenting Strategies, and Breaking Lockdown Rules

by Maria Grazia Melegari, Pietro Muratori, Oliviero Bruni, Enrica Donolato, Martina Giallonardo and Irene Mammarella

Children 2022, 9(6), 923; https://doi.org/10.3390/children9060923 - 20 Jun 2022

Cited by 3 | Viewed by 2371

Abstract

Lockdown experience for COVID-19 pandemic significantly affected children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) exacerbating or promoting the onset of externalizing and internalizing symptoms. However, few studies have considered how externalizing and internalizing behaviors changed in relation to parental emotions and parenting strategies. [...] Read more.

Lockdown experience for COVID-19 pandemic significantly affected children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) exacerbating or promoting the onset of externalizing and internalizing symptoms. However, few studies have considered how externalizing and internalizing behaviors changed in relation to parental emotions and parenting strategies. In the present study, 992 caregivers of children and adolescents with ADHD from 5 to 18 years were presented with an online survey evaluating youths’ externalizing and internalizing behaviors, their non-compliance with lockdown rules, and parental factors related to parental emotions and parenting strategies. Two hierarchical linear regression models were performed to examine the contribution of children’s non-compliance with lockdown rules, parental emotions, and parenting strategies on children’s externalizing and internalizing behaviors. Results revealed that externalizing behaviors were higher in children and adolescents with ADHD non-compliant with lockdown rules. Moreover, positive parenting strategies moderated the relationship between non-compliance with lockdown rules and externalizing behaviors. Differently, higher internalizing behaviors were observed in children with ADHD who had parents reporting more negative emotions and positive parenting strategies. In this case, parents’ negative emotions had a moderator effect in the association between internalizing behaviors and non-compliance to lockdown measures. The clinical implications of these two different patterns of relations are discussed. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

14 pages, 1157 KiB

Open AccessArticle

Oxidative and Inflammatory Markers Are Higher in Full-Term Newborns Suffering Funisitis, and Higher Oxidative Markers Are Associated with Admission

by Michi Kamei, Mohamed Hamed Hussein, Ayako Hattori, Marwa Saleh, Hiroki Kakita, Ghada Abdel-Hamid Daoud, Akio Ishiguro, Fumihiko Namba, Makoto Yazaki, Haruo Goto, Ineko Kato, Hisanori Sobajima, Kabe Kazuhiko, Koichi Moriwaki and Hajime Togari

Children 2022, 9(5), 702; https://doi.org/10.3390/children9050702 - 10 May 2022

Cited by 2 | Viewed by 1739

Abstract

The aim of this study was to assess whether oxidative and inflammatory mediators in the cord blood of newborns with funisitis and chorioamnionitis can serve as indicators of their inflammatory status, and whether there is a positive association between higher mediator levels and [...] Read more.

The aim of this study was to assess whether oxidative and inflammatory mediators in the cord blood of newborns with funisitis and chorioamnionitis can serve as indicators of their inflammatory status, and whether there is a positive association between higher mediator levels and an increased risk of admission to the neonatal intensive care unit (NICU). This study was conducted prospectively in a neonatology department of a university hospital. In total, 52 full-term newborns were evaluated, including 17 funisitis cases, 13 chorioamnionitis cases, and 22 control newborns without funisitis or chorioamnionitis. Cord blood samples were measured for oxidative stress and inflammatory status markers. The oxidative stress markers included the total nitric oxide (NO), total hydroperoxide (TH), biological antioxidant potential (BAP), and TH/BAP ratio, comprising the oxidative stress index (OSI). Inflammatory markers included interleukin (IL)-1b, IL-6, IL-8, IL-10, tumor necrosis factor alpha (TNFα), interferon γ (IFNγ), and complement component C5a. TH, OSI, IL-1b, IL-6, and IL-8 concentrations were higher in the funisitis group than in the chorioamnionitis and control groups. C5a was higher in the funisitis and chorioamnionitis groups than in the control group. Among all enrolled newborns, 14 were admitted to the NICU. Multiple logistic regression analysis showed that elevated umbilical cord blood levels of OSI and TH were associated with a higher risk of admission to the NICU (OSI: R = 2.3, 95% CI 1.26–4.29, p = 0.007 and TH: R = 1.02, 95%CI = 1.004–1.040, p = 0.015). In conclusion, OSI and TH in cord blood from full-term newborns can provide an index of inflammatory status, and higher levels are associated with the risk of admission to the NICU and, therefore, could serve as an early indicator of inflammatory conditions in newborns. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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Review

Jump to: Research, Other

13 pages, 700 KiB

Open AccessEditor’s ChoiceReview

PANDAS/PANS in the COVID-19 Age: Autoimmunity and Epstein–Barr Virus Reactivation as Trigger Agents?

by Stefano Pallanti and Michele Di Ponzio

Children 2023, 10(4), 648; https://doi.org/10.3390/children10040648 - 30 Mar 2023

Cited by 6 | Viewed by 4672

Abstract

COVID-19 impacted the entire world’s population, frequently resulting in long-lasting neuropsychiatric complications. Furthermore, social distancing, lockdowns and fear for one’s personal health worsen individual psychological wellbeing, especially in children and adolescents. Herein, we discuss the results of studies that specifically reported data about [...] Read more.

COVID-19 impacted the entire world’s population, frequently resulting in long-lasting neuropsychiatric complications. Furthermore, social distancing, lockdowns and fear for one’s personal health worsen individual psychological wellbeing, especially in children and adolescents. Herein, we discuss the results of studies that specifically reported data about the impact of the COVID-19 pandemic or infection on children with Pediatric Acute-Onset Neuropsychiatric Disorders (PANS). Furthermore, we present the cases of five adolescents with PANS whose symptomatology increased following SARS-CoV-2 infection. What emerged from this study was that COVID-19 resulted in the exacerbation of obsessions, tics, anxiety and mood symptoms and decreased wellbeing. Moreover, new symptoms, as well as new PANS cases, are reported to have arisen after COVID-19 infection. Here, we hypothesize that the pathogenic mechanisms of silent viruses, such as the Epstein–Barr virus, are related to neuroinflammation, immune responses and reactivation, with additional roles played by social-isolation-related inflammatory processes. The discussion of PANS, which represents a model of immune-mediated neuropsychiatric manifestations, is particularly relevant, with the aim of uncovering the mechanisms that lead to neuropsychiatric Post-Acute COVID-19 Syndrome (PACS). Prospects for future studies and treatment implications are discussed. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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17 pages, 3328 KiB

Open AccessReview

Common Errors in the Management of Idiopathic Clubfeet Using the Ponseti Method: A Review of the Literature

by Sean B. Youn, Ashish S. Ranade, Anil Agarwal and Mohan V. Belthur

Children 2023, 10(1), 152; https://doi.org/10.3390/children10010152 - 12 Jan 2023

Cited by 1 | Viewed by 2799

Abstract

Congenital talipes equinovarus is one of the most prevalent birth defects, affecting approximately 0.6 to 1.5 children per 1000 live births. Currently, the Ponseti method is the gold-standard treatment for idiopathic clubfeet, with good results reported globally. This literature review focuses on common [...] Read more.

Congenital talipes equinovarus is one of the most prevalent birth defects, affecting approximately 0.6 to 1.5 children per 1000 live births. Currently, the Ponseti method is the gold-standard treatment for idiopathic clubfeet, with good results reported globally. This literature review focuses on common errors encountered during different stages of the management of idiopathic clubfeet, namely diagnosis, manipulation, serial casting, Achilles tenotomy, and bracing. The purpose is to update clinicians and provide broad guidelines that can be followed to avoid and manage these errors to optimize short- and long-term outcomes of treatment of idiopathic clubfeet using the Ponseti method. A literature search was performed using the following keywords: “Idiopathic Clubfoot” (All Fields) AND “Management” OR “Outcomes” (All Fields). Databases searched included PubMed, EMBASE, Cochrane Library, Google Scholar, and SCOPUS (age range: 0–12 months). A full-text review of these articles was then performed looking for “complications” or “errors” reported during the treatment process. A total of 61 articles were included in the final review: 28 from PubMed, 8 from EMBASE, 17 from Google Scholar, 2 from Cochrane Library, and 6 from SCOPUS. We then grouped the errors encountered during the treatment process under the different stages of the treatment protocol (diagnosis, manipulation and casting, tenotomy, and bracing) to facilitate discussion and highlight solutions. While the Ponseti method is currently the gold standard in clubfoot treatment, its precise and intensive nature can present clinicians, health care providers, and patients with potential problems if proper diligence and attention to detail is lacking. The purpose of this paper is to highlight common mistakes made throughout the Ponseti treatment protocol from diagnosis to bracing to optimize care for these patients. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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11 pages, 1287 KiB

Open AccessReview

Diazoxide for Neonatal Hyperinsulinemic Hypoglycemia and Pulmonary Hypertension

by Shoshana Newman-Lindsay, Satyan Lakshminrusimha and Deepika Sankaran

Children 2023, 10(1), 5; https://doi.org/10.3390/children10010005 - 21 Dec 2022

Cited by 4 | Viewed by 4762

Abstract

Hypoglycemia in neonates is associated with long-term neurodevelopmental effects. Hyperinsulinemic hypoglycemia (HH) is the most common cause of persistent hypoglycemia in neonatal intensive care units. Diazoxide is the only medication that is currently recommended for treatment of HH in neonates. However, the use [...] Read more.

Hypoglycemia in neonates is associated with long-term neurodevelopmental effects. Hyperinsulinemic hypoglycemia (HH) is the most common cause of persistent hypoglycemia in neonatal intensive care units. Diazoxide is the only medication that is currently recommended for treatment of HH in neonates. However, the use of diazoxide in neonates is associated with pulmonary hypertension as an adverse effect. In this article, we review the literature on the mechanism of action and adverse effects with the use of diazoxide in neonatal hyperinsulinism. We then present a case series of neonates treated with diazoxide in our neonatal intensive care unit over a 5-year period. Among 23 neonates who received diazoxide, 4 developed pulmonary hypertension and 1 died. All infants who developed pulmonary hypertension were born preterm at less than 36 weeks gestation and had pre-existing risk factors for pulmonary hypertension. HH in preterm neonates, with pre-existing pulmonary hypertension or with risk factors for pulmonary hypertension requires thoughtful management. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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10 pages, 620 KiB

Open AccessReview

Diagnostic Pitfalls in Guillain–Barré Syndrome: Case Report and Literature Review

by Vasile Valeriu Lupu, Ingrith Miron, Anca Lavinia Cianga, Cristina Gavrilovici, Ioana Grigore, Alexandru Gabriel David, Leonard Iosif Pertea, Ecaterina Grigore, Diana Elena David and Ancuta Lupu

Children 2022, 9(12), 1969; https://doi.org/10.3390/children9121969 - 15 Dec 2022

Cited by 2 | Viewed by 4711

Abstract

Guillain–Barré syndrome (GBS) represents a group of acute immune-mediated polyradiculoneuropathies that is usually characterized by symmetrical limb weakness and areflexia. GBS can also lead to atypical clinical findings, which may lead to confusion and errors in the diagnosis. In this report, we describe [...] Read more.

Guillain–Barré syndrome (GBS) represents a group of acute immune-mediated polyradiculoneuropathies that is usually characterized by symmetrical limb weakness and areflexia. GBS can also lead to atypical clinical findings, which may lead to confusion and errors in the diagnosis. In this report, we describe a case of Guillain–Barré syndrome in a 7-year-old child who presented with neck stiffness, headache and vomiting mimicking acute meningoencephalitis, arthritis and myositis. Symptoms of ascending paralysis developed subsequently. Clearly, the atypical presentation of GBS is a significant dilemma for pediatricians and may lead to delays in diagnosis and treatment. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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14 pages, 585 KiB

Open AccessReview

Impact of Philosophy for Children and Its Challenges: A Systematic Review

by Mohd Kaziman Ab Wahab, Hafizhah Zulkifli and Khadijah Abdul Razak

Children 2022, 9(11), 1671; https://doi.org/10.3390/children9111671 - 31 Oct 2022

Cited by 3 | Viewed by 2882

Abstract

Philosophy for children (P4C) has been implemented worldwide. P4C has been researched empirically in order to evaluate its effectiveness and address the current lack of a systemic literature review of research on P4C. Therefore, this SLR study aims to identify how P4C positively [...] Read more.

Philosophy for children (P4C) has been implemented worldwide. P4C has been researched empirically in order to evaluate its effectiveness and address the current lack of a systemic literature review of research on P4C. Therefore, this SLR study aims to identify how P4C positively affects aspects other than students’ thinking and the challenges that teachers and students face in implementing the program. The methodology and writing method used was PRISMA (preferred reporting items for systematic review and meta-analysis). Articles and materials related to the topic were located primarily using two databases, Web of Science and Scopus. Using thematic analysis, this SLR derived five main themes, namely (1) higher-order thinking skills (HOTS), (2) safe environments, (3) civilized students, (4) democracy in discussion, and (5) the culture of thinking in the classroom. There are also challenges faced by teachers and students. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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13 pages, 306 KiB

Open AccessReview

Probiotics in Children with Asthma

by Giorgio Ciprandi and Maria Angela Tosca

Children 2022, 9(7), 978; https://doi.org/10.3390/children9070978 - 29 Jun 2022

Cited by 9 | Viewed by 3086

Abstract

A type-2 immune response usually sustains wheezing and asthma in children. In addition, dysbiosis of digestive and respiratory tracts is detectable in patients with wheezing and asthma. Probiotics may rebalance immune response, repair dysbiosis, and mitigate airway inflammation. As a result, probiotics may [...] Read more.

A type-2 immune response usually sustains wheezing and asthma in children. In addition, dysbiosis of digestive and respiratory tracts is detectable in patients with wheezing and asthma. Probiotics may rebalance immune response, repair dysbiosis, and mitigate airway inflammation. As a result, probiotics may prevent asthma and wheezing relapse. There is evidence that some probiotic strains may improve asthma outcomes in children. In this context, the PROPAM study provided evidence that two specific strains significantly prevented asthma exacerbations and wheezing episodes. Therefore, oral probiotics could be used as add-on asthma therapy in managing children with asthma, but the choice should be based on documented evidence. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

Other

Jump to: Research, Review

10 pages, 514 KiB

Open AccessSystematic Review

Allografts for Medial Patellofemoral Ligament (MPFL) Reconstruction in Adolescent Patients with Recurrent Patellofemoral Instability: A Systematic Review

by Filippo Migliorini, Nicola Maffulli, Stefan Söllner, Mario Pasurka, Joshua Kubach, Andreas Bell and Marcel Betsch

Children 2023, 10(5), 840; https://doi.org/10.3390/children10050840 - 06 May 2023

Viewed by 1245

Abstract

This systematic review updates the currently available evidence on medial patella-femoral ligament (MPFL) reconstruction using allografts. The outcomes were measured with patient-reported outcome measures (PROMs), redislocation and complication rates. This study was performed according to the 2020 PRISMA guidelines using the PubMed, Scopus, [...] Read more.

This systematic review updates the currently available evidence on medial patella-femoral ligament (MPFL) reconstruction using allografts. The outcomes were measured with patient-reported outcome measures (PROMs), redislocation and complication rates. This study was performed according to the 2020 PRISMA guidelines using the PubMed, Scopus, Web of Science databases, accessed in February 2023. Studies examining the clinical outcomes of MPFL reconstruction with allografts in adolescents and children with recurrent patellofemoral instability (PFI) were included. Data from three trials, including 113 surgical procedures in 121 children, were retrieved. 40% (48/121) of the included patients were girls. The mean age of the patients was 14.7 ± 0.8 years, and the mean follow-up length was 38.1 ± 16.5 months. With MPFL allograft reconstruction, the Kujala score improved by 14.7% (p < 0.0001) and the IKDC by 38.8% (p < 0.0001). The rate of dislocations was 5% (6 of 121), reoperation for instability was 11% (13 of 121), and subluxation was 2% (1 of 47). Conclusion: These results encourage the use of allografts for MPFL reconstruction in adolescent patients with recurrent patellofemoral instability. Though patellofemoral instability is common in clinical practice, the current literature lacks clinical evidence on allograft MPFL reconstruction. Additional high-quality investigations are required to properly establish the long-term advantages of allograft MPFL and its complication rate. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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9 pages, 248 KiB

Open AccessProtocol

Health Outcomes of Children Living in Out-of-Home Care in Metropolitan Western Australia: A Sequential Mixed-Methods Study—A Protocol Paper

by Hope Kachila, Caroline Bulsara, Brad Farrant, Alice Johnson, Carol Michie and Charmaine Pell

Children 2023, 10(3), 566; https://doi.org/10.3390/children10030566 - 16 Mar 2023

Viewed by 1218

Abstract

The research protocol described aims to examine and establish the health outcomes of children and young people living in Out-of-Home Care (OOHC) in Perth, Western Australia (WA) from the perspective of the care recipients and service providers. A Study Advisory Panel (SAP) will [...] Read more.

The research protocol described aims to examine and establish the health outcomes of children and young people living in Out-of-Home Care (OOHC) in Perth, Western Australia (WA) from the perspective of the care recipients and service providers. A Study Advisory Panel (SAP) will be established comprised of Aboriginal Elders (because of the over-representation of Aboriginal children in OOHC), health professionals and other relevant stakeholders to help co-design all phases of the study. Mixed methods will be used in data collection and analysis. In the quantitative phase, it is proposed to collect retrospective data from three WA Department of Communities (DOC) districts. The data proposed to be collected includes: the number of children who received initial and annual health assessments, the health needs identified, and interventions put in place to address these needs. The qualitative phase will consist of interviews with service recipients (young people who have exited OOHC and Carers), health service providers (Community Health Nurses, School Nurses, General Practitioners and Paediatricians) and OOHC Case Workers. The research will provide an overview of the current health needs of children and young people in OOHC in WA and the perspectives of these young people, their Carers and service providers on current processes for accessing healthcare. It is anticipated that the study will provide valuable evidence for quality improvement in health service delivery to better meet the health needs of children and young people in OOHC. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

7 pages, 249 KiB

Open AccessBrief Report

Mental Health in Children, Adolescents, and Youths Living with Perinatally Acquired HIV: At the Crossroads of Psychosocial Determinants of Health

by Álvaro Vázquez-Pérez, Carlos Velo, Luis Escosa, Teresa García-Lopez, Jose I. Bernardino, Eulalia Valencia, Rafael Mican, María José Mellado and Talía Sainz

Children 2023, 10(2), 405; https://doi.org/10.3390/children10020405 - 18 Feb 2023

Cited by 2 | Viewed by 1291

Abstract

Here, we aim to describe mental health (MH) in a cohort of children, adolescents, and young adults living with perinatally acquired HIV (PHIV) in Spain and explore the treatment gap for mental disorders. We also aim to analyze the potential association between MH [...] Read more.

Here, we aim to describe mental health (MH) in a cohort of children, adolescents, and young adults living with perinatally acquired HIV (PHIV) in Spain and explore the treatment gap for mental disorders. We also aim to analyze the potential association between MH issues to psychosocial risk factors (PSRFs) and identify management priorities. We conducted a descriptive transversal study that included all cases of PHIV under follow-up in a reference hospital in Madrid. The study included patients undergoing follow-up in the pediatric outpatient clinic and youths transferred from pediatric to adult care units after 1997. Epidemiological, clinical, immunovirological, and treatment-related data were collected, including PSRF and adverse childhood experiences (ACEs). Of the 72 patients undergoing follow-up, 43 (59.7%) had already been transferred to the adult outpatient clinic. The patients’ median age was 25 years (IQR 18–29), and 54.2% were women. Most patients were undergoing treatment (94.6%) and were virologically suppressed (84.7%). Although MH issues were present in 30 patients (41.7%), only 17 (56.7%) had been referred for evaluation to the Department of Mental Health, and only 9 (30%) had received a MH diagnosis. PSRFs were common (32% of participants had at least one PSRF) and were associated with MH issues and adherence issues (all p < 0.05). A multidisciplinary approach to address the psychological factors and social determinants of health is urgently needed, particularly during important life development stages, such as adolescence. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

12 pages, 442 KiB

Open AccessPerspective

Avoidance Measures for Patients with Allergic Rhinitis: A Scoping Review

by Miguel Tomé and Olga Lourenço

Children 2023, 10(2), 300; https://doi.org/10.3390/children10020300 - 03 Feb 2023

Cited by 1 | Viewed by 1621

Abstract

Environmental allergen control is recommended as an essential part of allergic rhinitis (AR) management guidelines. In this scoping review, our objective is to identify measures of allergen avoidance and to evaluate their effectiveness in the management of AR. We conducted systematic searches for [...] Read more.

Environmental allergen control is recommended as an essential part of allergic rhinitis (AR) management guidelines. In this scoping review, our objective is to identify measures of allergen avoidance and to evaluate their effectiveness in the management of AR. We conducted systematic searches for randomized controlled trials and observational studies in PubMed, the Cochrane Central Register of Controlled Trials, and the Web of Science databases. We included all types of control measures based on allergen eviction or reduction in exposure. Overall, 18 studies satisfied our criteria and were thus included for further analysis. The majority of the studies (15 out of 18) reported decreases in overall AR symptom scores, improvements in quality of life, or reductions in medication usage. However, due to the low number of participants and the limitations in study designs, it is not possible to make a definitive recommendation on the use of these interventions in the management of AR. A multifaceted approach, including treatment, prevention, and eradication of allergens from the environment, may be necessary to effectively reduce symptoms. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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10 pages, 265 KiB

Open AccessBrief Report

Effects of Lockdown for COVID-19 Pandemic on Chronic Kidney Disease Progression in Children with Congenital Anomalies of the Kidney and Urinary Tract: A Retrospective Pilot Study

by Pier Luigi Palma, Anna Di Sessa, Antonio Paride Passaro, Eleonora Palladino, Giuseppe Furcolo, Annalisa Barlabà, Giulio Rivetti, Maeva De Lucia, Emanuele Miraglia del Giudice, Stefano Guarino and Pierluigi Marzuillo

Children 2023, 10(1), 123; https://doi.org/10.3390/children10010123 - 06 Jan 2023

Cited by 1 | Viewed by 1325

Abstract

The coronavirus disease 2019 (COVID-19) pandemic changed adults and children’s lifestyle. We focused our attention on children affected by chronic kidney disease (CKD) due to congenital abnormalities of kidney and urinary tract (CAKUT) and their behavior during the lockdown. Our aims were to [...] Read more.

The coronavirus disease 2019 (COVID-19) pandemic changed adults and children’s lifestyle. We focused our attention on children affected by chronic kidney disease (CKD) due to congenital abnormalities of kidney and urinary tract (CAKUT) and their behavior during the lockdown. Our aims were to evaluate the incidence of CKD progression within 6 months after the end of the first Italian lockdown and the factors associated to it. CKD progression was defined by the transition to higher CKD stage or by the drop in estimated glomerular filtration rate by a 25% or more for patients belonging to CKD stages 1 and 2. We retrospectively selected 21 children with CAKUT and CKD ≥ stage 1 observed within 3 months before and 6 months after the first Italian lockdown. We called them by phone and asked them about their lifestyle before and during lockdown focusing on physical activity, screen time, sweet/candies/sugar-sweetened beverages eaten/drunk and adherence to the Mediterranean diet (MD) (through KIDMED questionnaire). We calculated and analyzed the delta between the pre- and post- lockdown observation of all collected parameters (clinical and biochemical parameters and questionnaires scores). Analyzing the overall cohort, we found significantly increased mean BMI and mean screen time and significantly lower mean physical activity time in post- compared with pre-lockdown observations. Eleven out of twenty-one patients (52.4%) had a worsening of CKD. These patients presented higher delta of levels of uric acid and microalbuminuria and showed minor adherence to the MD and declared to have consumed more sweets or candies or sugar-sweetened beverages/week during the lockdown with a tendentially major increment of BMI compared with patients not presenting CKD progression. In conclusion, the lockdown for COVID-19 pandemic determined increase of BMI in all enrolled patients due to a “forced” negative lifestyle. About half of these patients presented CKD progression. This progression was associated to less adherence to the MD and major consumption of sweets or candies or sugar-sweetened beverages. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

11 pages, 1579 KiB

Open AccessBrief Report

Developmental Population Pharmacokinetics-Pharmacodynamics of Meropenem in Chinese Neonates and Young Infants: Dosing Recommendations for Late-Onset Sepsis

by Yue-E Wu, Chen Kou, Xue Li, Bo-Hao Tang, Bu-Fan Yao, Guo-Xiang Hao, Yi Zheng, John van den Anker, Dian-Ping You, A-Dong Shen and Wei Zhao

Children 2022, 9(12), 1998; https://doi.org/10.3390/children9121998 - 19 Dec 2022

Cited by 2 | Viewed by 1681

Abstract

The pharmacokinetic (PK) studies of meropenem in Chinese newborns with late-onset sepsis (LOS) are still lacking. Causative pathogens of LOS and their susceptibility patterns in China differ from the data abroad. We, therefore, conducted a developmental population pharmacokinetic–pharmacodynamic analysis in Chinese newborns with [...] Read more.

The pharmacokinetic (PK) studies of meropenem in Chinese newborns with late-onset sepsis (LOS) are still lacking. Causative pathogens of LOS and their susceptibility patterns in China differ from the data abroad. We, therefore, conducted a developmental population pharmacokinetic–pharmacodynamic analysis in Chinese newborns with the goal to optimize meropenem dosing regimens for LOS therapy. An opportunistic sampling strategy was used to collect meropenem samples, followed by model building and validation. A Monte Carlo simulation was performed to show the probability of target attainment (PTA) for various dosages. The information from 78 newborns (postmenstrual age: 27.4–46.1 weeks) was compiled and had a good fit to a 1-compartment model that had first order elimination. The median (range) values of estimated weight–normalized volume of distribution (V)and clearance (CL) were 0.60 (0.51–0.69) L/kg and 0.16 (0.04–0.51) L/h/kg, respectively. Covariate analysis revealed that postnatal age (PNA), gestational age (GA) and current weight (CW) were the most important factors in describing meropenem PK. Simulation results showed for LOS with a minimal inhibitory concentration (MIC) of 8 mg/L, the doses of 30 mg/kg 3 times daily (TID) as a 1-h infusion for newborns with GA ≤ 37 weeks and 40 mg/kg TID as a 3-h infusion for those with GA > 37 weeks were optimal, with PTA of 71.71% and 75.08%, respectively. In conclusion, we proposed an evidence-based dosing regimen of meropenem for LOS in Chinese newborns by using the population pharmacokinetic–pharmacodynamic analysis, based on domestic common pathogens and their susceptibility patterns. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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8 pages, 404 KiB

Open AccessCommentary

Palliative Sedation Therapy in Pediatrics: An Algorithm and Clinical Practice Update

by Andrea Cuviello, Liza-Marie Johnson, Kyle J. Morgan, Doralina L. Anghelescu and Justin N. Baker

Children 2022, 9(12), 1887; https://doi.org/10.3390/children9121887 - 01 Dec 2022

Cited by 2 | Viewed by 2160

Abstract

Palliative sedation therapy (PST) is an important clinical intervention for pediatric patients with refractory symptoms and suffering during the end-of-life (EOL) period. Variations in PST implementation including medication selection, limited literature regarding feasibility in various clinical settings, particularly non-intensive care units, and lack [...] Read more.

Palliative sedation therapy (PST) is an important clinical intervention for pediatric patients with refractory symptoms and suffering during the end-of-life (EOL) period. Variations in PST implementation including medication selection, limited literature regarding feasibility in various clinical settings, particularly non-intensive care units, and lack of education on evolving definitions and ideal practices may all contribute to the current underutilization of this valuable resource. We therefore offer a clinical algorithm for identifying appropriate patients for PST, ensuring all other modalities for symptom management have been considered and/or optimized, and present a guideline for PST implementation that can be adapted and individualized based on institutional experience and resource availability. Furthermore, through case-based clinical scenarios, we demonstrate how to incorporate this algorithm into EOL practice. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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7 pages, 1108 KiB

Open AccessCase Report

18p Deletion Syndrome Originating from Rare Unbalanced Whole-Arm Translocation between Chromosomes 13 and 18: A Case Report and Literature Review

by Ji Young Choi, Ja Un Moon, Da Hye Yoon, Jisook Yim, Myungshin Kim and Min Ho Jung

Children 2022, 9(7), 987; https://doi.org/10.3390/children9070987 - 01 Jul 2022

Viewed by 2328

Abstract

18p deletion (18p-) syndrome is a rare chromosome abnormality that has a wide range of phenotypes, with short stature, intellectual disability, and facial dysmorphism being the main clinical features. Here, we report the first case in Korea of a 16-year-old male adolescent with [...] Read more.

18p deletion (18p-) syndrome is a rare chromosome abnormality that has a wide range of phenotypes, with short stature, intellectual disability, and facial dysmorphism being the main clinical features. Here, we report the first case in Korea of a 16-year-old male adolescent with 18p- syndrome resulting from de novo unbalanced whole-arm translocation between chromosomes 13 and 18 (45, XY, der(13;18)(q10:q10)). Three rare clinical findings were discovered that had not been reported in the previous literature; morbid obesity without other hormonal disturbances, rib cage deformity leading to the direct compression of the liver, and lumbar spondylolisthesis at the L5-S1 level. This case expands the phenotypic spectrum of 18p- syndrome and highlights the importance of considering chromosomal analysis, since this syndrome can be easily overlooked in a clinical setting, especially without distinctive symptoms of other organs, due to its nonspecific but typical features of short stature and mild intellectual disability with a mildly dysmorphic face. Moreover, since not all cases of 18p- syndrome with unbalanced translocation (13;18) show the same phenotype, multidisciplinary examinations and follow-up seem to be important to monitor evolving and developing clinical manifestations and to predict prognosis in advance associated with the specific genes of 18p breakpoint regions. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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